EFTA00120663¶
FEB 04¶
U. S. DEPARTMENT OF JUSTICE¶
FEDERAL BUREAU OF PRISONS¶
ARRESTING OFFICER WILL COMPLETE ALL REQUIRED DATA ON THIS FORM PRIOR TO COMMITTING TO MCC/MDCs.¶
| Name: Last | SANTANA | First | JOSE | Register Number | 77575-054 | PICTURE |
|---|---|---|---|---|---|---|
| AKAs: COLON JONATHAN | Middle |
Race (Check) B W A I Sex (Check) M F Ethnic Origin (Check) Hispanic or Other D.O.B. 8109176 SSN: 81466-8488 FBI: 851005V46 INS: Other:¶
CHARGES CHECK CATEGORY OF CHARGES(S):¶
- FELONY
- MISDEMEANOR
- CIVIL CONTEMPT
- MATERIAL WITNESS
OTHER NARRATIVE: Title: USC:3653 VOSR NARRATIVE: Title: USC:¶
Date of Offense: Date of Arrest: Place of Arrest: River’s Island¶
State of Birth NY Country of Birth US Citizenship US Current Address: 4913520518 St Oct 114 Zip Code: 104603¶
Height FT: In:07 Weight 185 Hair BLK Eyes BBLK Scars / Marks / Tattoos¶
Injuries / Medication¶
Emergency Contact:(Name, Address, Phone Number)¶
Arraigned Y N Sentenced Y N Special Handling: Y or N Remarks:¶
| IN | IN | IN | IN |
|---|---|---|---|
| Remanding Official (Name) Sign Print | Agency/District USms/SDNY | Phone/24 Hour Number 212-331-7200 | |
| OUT | OUT | OUT | OUT |
| Removing Official (Name) Sign Print | Agency/District | Phone/24 Hour Number |
FOR BOP USE ONLY¶
Receiving Official (Name) Date / Time Releasing Official (Name) Date / Time Sign Print¶
Sentry Load Data: (Must Initial) Name Search Completed by: Create Cash Account Deposit Cash Amt. Detainers Court Clothing Bag #¶
(OPTIONAL USE): Staff Init. RIGHT THUMBPRINT¶
Original-for ISM as Remanding-Removal receipt; Copy-for Control as Removal Receipt (NCIC); Copy-For Removing Official; Copy-for Control as Remanding Receipt (Inmate); Copy-INS-Alien in Custody.¶
(This form may be replicated via WP) This form replaces BP-S377(58) and BP-377(58) of JUL 91¶